Abstract: A system and method to manage delivery of healthcare via a plurality of resources to a patient is provided. The system and method track and output a signal representative of a location of at least one of a series of resources relative to a control volume associated with the patient, acquire at least one signal representative of detecting ingress or egress of at least one of the plurality of resources relative to the control volume; and output a first signal representative of one of a series of milestones as defined in a predetermined protocol in response to detecting ingress or egress of at least one of the resources relative to the control volume.

Abstract: Medical devices, systems and related methods for delivering a tissue anchor. The medical devices generally comprise a needle and a sheath that assist in retaining the tissue anchor at the distal end of the need during manipulation of the medical device. The medical systems include one or more tissue anchors in conjunction with one of the medical devices.

Abstract: In accordance with the present invention there is provided a suturing device. The suturing device includes a length of suture that will be delivered to the site of the PFO and placed through the tissue adjacent the opening to close the PFO. As described in greater detail below, the suture is advanced through the tissue surrounding the opening by a pair of needles that penetrate the tissue adjacent to the opening. A knot is then loosely tied with the length of suture and advanced to the site of the PFO. The tails of the suture extending from the knot are then cut and removed. It is also contemplated that a pre-formed or pre-tied knot may be disposed on the device, wherein after deployment of the suture through the tissue adjacent to the PFO and removal of the device a loop of suture having a pre-tied knot will remain, wherein the pre-tied knot may then be tightened to close the PFO. Further still it is contemplated that other means may be utilized to retain the sutures.

Abstract: A nontraumatic two-point needle for surgical suture having two or more modular components constituted by hollow and solid needle portions to be assembled by locking the suture line, or lines, inside the hollow portion or portions.

Abstract: A device for suturing an opening in a tissue, having an elongated shaft, at least two arms movable to a deployed positioning which the arms are non-perpendicular to the shaft, the arms having needle receiving portions; and needles advanceable longitudinally along the shaft toward the needle receiving portions, the needles exiting through side walls of the shaft at a location proximal to the arms.

Abstract: A multifunctional suture needle that may be used to draw a suture through tissue surrounding a wound while simultaneously delivering a bioactive fluid through the needle tip. The suture needle possesses an internal cavity capable of containing a fluid, and a fine aperture adjacent to the point of the needle through which the fluid may egress. The fluid may be driven from the needle through the needle tip with a compressed gas that is sealed within the cavity adjacent to the fluid. Alternatively a fluid conducting suture may be employed to deliver fluid through the internal passage of the suture needle and out the aperture adjacent to the tip of the needle. The rate at which the fluid is emitted from the suture needle may be controlled by carefully selecting the fluid viscosity, design of the needle or suture passages, and pressure applied to the fluid.

Abstract: A needle delivery device is described and includes generally, a needle made of a shape memory alloy pre-formed in an unconstrained configuration, such as, for example, an arc or a curved needle. The needle delivery device also includes a needle delivery guide, a suturing guide and a positioning member. The needle has an eye at its leading tip for holding suture material. The needle delivery guide has a needle channel for passage of the needle therethrough. The needle channel is configured to hold the needle in a constrained configuration, for example, in substantial alignment with the longitudinal axis of the needle channel. The suturing guide is pivotally connected to the delivery guide.

Abstract: Suturing instruments in accordance with the invention are dimensioned and configured to apply sutures to approximate, ligate, or fixate tissue in, for example, open, mini-incision, trans-vaginal, laparoscopic, or endoscopic surgical procedures. In some embodiments, the suturing instruments include a distal portion that is deflectably and/or pivotally coupled to the remainder of the instrument for improved maneuverability and functionality during surgery. In other embodiments, the suturing instruments are capable of housing multiple needle and suture assemblies and/or reloading the needle and suture assembly without removing the instrument from the surgical site.

Abstract: The invention essentially relates to a surgical needle (17) comprising a long hollow body (18) and two ends (19, 20). The body (18) comprises a ventral wall (21) and a dorsal wall (22) which are connected to one another. According to the invention, the dorsal wall (22) and the ventral wall (21) extend along the long axis of the needle (17). Each of the two ends (19, 20) comprises a hollow beveled tip (23, 24). The needle (17) also comprises a hole (25) which is provided in the dorsal wall (22) of the body (18) and a slit (26) which is provided in the ventral wall (21). In this way, a suture (30) can slide inside the hollow body (18) of the needle, the suture being retained in position by the knot (29) or means for stopping thereof. For said purpose, the smallest diameter (27) of the hole (25) is greater than the largest width (28) of the slit (26).

Abstract: A surgical thread and a surgical device. The surgical thread includes at least two adjacent elongated elements that are connected to each other and include filament fibers such that a maximum cross-sectional diameter of the thread is substantially greater than the cross-sectional diameter of the thread in the direction perpendicular to the maximum diameter, and the elements are connected by a structure that is arranged to be broken at least at the ends of the elements such that the thread can be divided into single elements. The surgical device includes a needle and a surgical thread attached to the surgical needle.

Abstract: In accordance with one or more embodiments, a Counting Device Assembly is capable of counting a number of times a surgical implement causes an incision during a surgical procedure.

Abstract: A surgical kit includes an applicator instrument and a needle assembly. The needle assembly provides two spaced pathways and carries a surgical fastener. One anchor of the surgical fastener is carried by one of the pathways and another anchor of the fastener is carried by the other pathway. A filament connects the two anchors of the fasteners and extends between the pathways. The applicator allows for simultaneous insertion of both anchors of the fastener at spaced locations with the filament extending from both anchors in the tissue and over the surface of the tissue or of a therapeutic implant fixated to the tissue. The needle assemblies may be removed from the applicator. The kit may include several needle assemblies that may be attached to the applicator in series to create a plurality of mattress-type stitches.

Abstract: Suture-based fasteners and fastening methods for soft tissue reconstruction are described that can include a needle tip swaged onto two sutures and loaded onto the end of a curved needle shaft. The needle shaft and tip can be driven through the tissues to be sutured and back out to where the needle tip can make a permanent connection with a locking bead. The needle shaft can be retracted, leaving two sutures extending from the side of the bead. One suture can be of nonabsorbable material and can be brought through the end of the locking bead opposite the tip and pulled to tighten the suture loop. The other suture can be of an absorbable material and can be used to rotate the locking bead under one of the layers of tissue being sutured after the suture loop is tightened. Following rotation, the second suture can be trimmed.

Abstract: A cycling suturing and knot-tying device is characterized by an arcuate fixed, grooved or recessed way provided in a correspondingly-shaped support frame for accommodating a curved needle fitted with thread, and frictional needle-engaging devices provided in the way for selectively engaging the needle and driving the needle in one or both rotational directions to suture a wound with the thread. Selective articulation of the frame and the way and driving of the needle in the way by positioning the frictional needle-engaging devices with respect to the needle are typically effected by manipulation of a pistol-grip operating apparatus having a transmission tube that mounts the frame and the way in articulating relationship and rotates and articulates with respect to the pistol grip and carries various operating elements that interface with the frictional needle-engaging devices in the way.

Abstract: A high strength surgical suture formed of ultrahigh molecular weight polyethylene (UHMWPE) yarns, the suture being coated with native or denatured collagen. The braided jacket surrounds a core formed of twisted yarns of ultrahigh molecular weight polyethylene. The suture has exceptional strength, is ideally suited for most orthopedic procedures, and can be attached to a suture anchor or a curved needle.

Abstract: A suture and needle combination is disclosed for use during surgical and non-surgical procedures comprising a suture needle 16 with a breakaway tip 20, insertable tip 24 or reusable tip 32. Suture 10 passes freely through hollow needle 16 after a user removes needle tip (20,24, or 32) during use. This suture needle combination reduces the amount of room needed within a surgical site, reduces the length of needle 16 needed to exit tissue (for example) while suturing, and decreased trauma to at risk anatomical structures during a surgical procedure or other use.

Abstract: A high strength surgical material with improved tie down characteristics and tissue compliance formed of ultrahigh molecular weight polyethylene (UHMWPE) yarns, the suture being coated with arginine-glycine-aspartate (RGD) peptide. The suture has exceptional strength, is ideally suited for most orthopedic procedures, and can be attached to a suture anchor or a curved needle.

Abstract: A pull-locking rotational action needle driver that comprises an ergonomically designed handle and an integrated locking system that permits left and right handed surgeons to perform the surgical suturing procedure in a less complicated and more secure way by allowing more control over the suturing needle and the area to be stitched, even when the suturing area is small, deep, and/or restricted.

Abstract: A system and method for tissue repair employing a continuous loop of suture attached to a free floating needle. The free floating needle is not swaged on the suture so that, after passing the suture loop construct through the tissue to be treated, the needle may be recentered if the suture strands are uneven.

Abstract: A surgical suturing device has a body with a “J”-shaped suturing needle attached. One end of a movable arm is pivotably attached to the body so that the other end of the movable arm may swing into and out of engagement with the tip of the suturing needle. The movable arm is engaged by a rod that slides transversely within the body. The moveable arm swings in response to pressure on a thumb nut that moves the rod. Rod movement is resisted by a compression spring within the body. The device allows a surgeon to suture the fascial layer from within a surgical incision. The surgeon avoids unwanted penetration of tissue by pressing the thumb nut to cause the movable arm to engage and cover at least a portion of the needle tip.

Abstract: A knot placer has a rod (10) connecting a handle end (11) to a working end (12). The working end (12) has a closed leg eyelet (15) and a slit leg eyelet (16). A slidable knot (27), formed from a pair of ends of surgical suture (25a) and (25b) is used to join a patient's tissue. The knot (27) can be transferred through an access port (21) and tightened at a surgical site (26) by threading each respective suture end (25a) and (25b) into each eyelet (15) and (16), grasping the handle end (11), and pushing the slidable knot (27) to the surgical site (26) during an endoscopic surgery. Subsequently, the knot placer can be pulled out of the access port (21), and the slit eyelet (16) can release its respective suture end (25a) or (25b) through the slit (19). Another slidable knot (27) can be tied.

Abstract: Polymeric nanofibers have been developed which are useful in a variety of medical and other applications, such as filtration devices, medical prosthesis, scaffolds for tissue engineering, wound dressings, controlled drug delivery systems, cosmetic skin masks, and protective clothing. These can be formed of any of a variety of different polymers, either non-degradable or degradable. In a preferred embodiment demonstrated in the following examples, nanofibers are formed of biodegradable and non biodegradable polyphosphazenes, their blends with other polyphosphazenes or with organic, inorganic/organometallic polymers as well as composite nanofibers of polyphosphazenes with nanosized particles such as hydroxyapatites.

Abstract: A linear surgical needle is provided having a body portion including a proximal end section; a central section; and a distal end section. The distal end section has a substantially parabolic configuration for producing a substantially uniform stress profile along a length thereof.

Abstract: A prosthetic screen tacking device includes a barbed filament with a perpendicular foot at one end and a loop at the other. The barbs are situated near the foot and angulated in such a manner that they permit movement of the device through tissue in one direction (toward the loop), but prevent movement in the opposite direction (toward the foot). Different barbs and feet are shown. Methods of using the device with or without an associated button are also disclosed.

Abstract: An apparatus used with a helical suture device has a first end and a second end. The first end includes a spatulate member having a length along a first axis. The second end includes a guide shaped to receive a cylindrical axle of the helical suture device for rotation on a second axis. The guide is shaped to constrain the first axis in fixed position relative to the second axis, the first and second axes each lying within a plane. The spatulate member extends, typically symmetrically, in a first direction and a second direction from the first axis, the first direction and second direction being on opposite sides of the plane. The apparatus lies between a first tissue that is to be sutured, and a second tissue that is desired not to be sutured.

Abstract: A surgical element carrier and method for use is provided, wherein the surgical element carrier includes a housing dimensioned to contain therein a plurality of surgical elements, and dimensioned for insertion through a surgical port used in minimally invasive surgeries. The housing further includes a first housing portion and a second housing portion movable relative to the first housing portion between a closed position wherein the surgical elements are substantially surrounded by the housing, and an open position wherein the surgical elements are at least partially exposed and removable from the housing.

Abstract: A method for siliconizing surgical needles is provided whereby the needles are treated with acid before they are siliconized.

Abstract: A suture punch system that is capable of directly passing braided suture through tissue in a simple, one-step process. The system includes three principle components: a malleable needle capable of delivering the suture to the tissue, a handheld instrument for grasping tissue and controlling needle placement, and a force-supplying mechanism to supply the force required for needle placement. Needle deformation begins at the tip of the instrument, which beneficially includes a curved segment. As the distal tip of the needle pierces the tissue, it continues its radial path through the tissue. When the proximal end of the needle exits from the instrument, the needle may be radial in shape and traverses an essentially radial path through the tissue. Non-radial linear or non-linear segments may alternatively be used. In one embodiment, the tissue to be sutured is constrained by pressure applied through closure between an upper, moveable jaw at the distal portion of the instrument, which acts as a fixed jaw.

Abstract: A suturing instrument for placing mattress stitches in soft tissue, such as a rotator cuff, includes an elongate shaft with both a stationary jaw and a movable jaw disposed at the distal end thereof. The shaft is coupled to a handle grip at the proximal end, which is configured to manipulate the jaws into open and closed positions. The jaws are configured to allow for atraumatic grasping of soft tissues. The stationary jaw may include a molded tip that holds and positions opposite ends of a single strand of suture material. The serrated upper jaw is configured to grasp and immobilize the tissue to be sutured. Hooked needles are movably positioned to pierce the grasped and immobilized tissues, and to engage and retrieve the opposite ends of the single strand of suture material. The handle is released to open the moveable jaw, whereupon the instrument may be withdrawn, trailing the suture, and leaving a mattress stitch in the grasped tissue.

Abstract: A system for performing minimally invasive cardiac procedures. The system includes a pair of surgical instruments that are coupled to a pair of robotic arms. The instruments have end effectors that can be manipulated to hold and suture tissue. The robotic arms are coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the end effectors. The movement of the handles is scaled so that the end effectors have a corresponding movement that is different, typically smaller, than the movement performed by the hands of the surgeon. The scale factor is adjustable so that the surgeon can control the resolution of the end effector movement. The movement of the end effector can be controlled by an input button, so that the end effector only moves when the button is depressed by the surgeon.

Abstract: A surgical instrument (10) intended for use in location of a filament in a body, where the instrument comprises a rigid shaft (12) having a handle (14) at one end (16), the other end (18) of the shaft being convergent and formed with an eye (22) adjacent to the other end, the eye being dimensioned to receive the filament, the shaft being curved in a portion proximate the other end.

Abstract: A closure device for sealing a percutaneous puncture in the wall of a blood vessel includes: an insertion tool having an actuator which is operable in a first mode in which the actuator is configured for deployment of an inner seal inside the vessel and operable in a second mode in which the actuator is configured for tamping a locking member on an outside of the vessel, where the actuator is arranged to be set into the second mode in response to a pulling force acting on a filament connecting the inner seal and the locking member.

Abstract: Sutures can be reliably applied to the tissue of sensitive organs in a predetermined and limited depth with minimal surgical skills through the use of a curved suture needle and a suture control apparatus. The suture control apparatus, which can be adjustable, comprises a pair of needle guides that are separated by a space, and a locator surface for engagement with the suture-receiving tissue in the space between the needle guides, with the pair of needle guides and locator surface being preferably carried by a handle. Preferably, the pair of needle guides are curved to provide a radius of curvature substantially equal to the radius of curvature of the curved suture needle.

Abstract: A suturing apparatus comprises a pair of jaws. A bendable needle housed in one of the jaws is adapted to carry a suture. An optional suture receiver may be disposed adjacent to the opposite jaw. A transition block curves the needle and directs it in a direction generally unparallel to an axis of the carrying jaw. The needle may also be configured to retrieve a suture. A retaining mechanism holds a suture in place to be engaged by the needle. The jaw housing the needle may include a lateral opening through which the suture may be inserted. The needle may also include a lateral notch which may be aligned with lateral opening to receive the suture. An actuator coupled to the needle enables the user to move the needle proximally to align the notch with the lateral slot.

Abstract: A clip for suturing opposed ends of severed tissue. The clip has a body with a first end terminating in a needle and a second end having an opening thereat. The body may also include a bite portion between the first and second ends applying a biasing force to hold the suturing clip in either a default open or default closed condition, wherein the needle is remote from the opening in the open condition and in proximity to the opening in the closed condition. The body may also include a footpad adjacent the needle, wherein the footpad pinches the opposing ends of the severed tissue against the body adjacent to the opening when the clip is in the closed condition. The clips may be applied by a surgical device, which is also disclosed.

Abstract: The present invention provides new and useful devices and techniques for use in suturing. These devices and techniques are particularly useful in laparoscopic, arthroscopic, and/or open surgical procedures. A method according to the present invention is characterized by releasably coupling a suture to a suture device, causing the tip of the suture device and a portion of the suture to penetrate a tissue, and releasing the suture from the suture device, so the suture may be drawn through the tissue for completion of a suturing procedure. One type of suturing device according to the invention is characterized by a handle with an elongated shaft with a sharpened tip configured to hold a suture at a selected point on the suture. Another type of device according to the principles of the invention is characterized by new and useful structures and techniques for loading the suture into the device.

Abstract: A tissue fixation device may include a suture, a first securing element connected to a first portion of the suture, and a second securing element connected to a second portion of the suture. The first and second securing elements are each rotatable from a first position during deployment of the tissue fixation device that is suitable for each securing element to pass through a respective hole formed in tissue to a second position when the tissue fixation device is deployed that inhibits each securing element from passing through the respective hole formed in the tissue. An exemplary method of fixing tissue may include creating two holes in the tissue and deploying a tissue fixation device having a suture connecting two securing elements by advancing each securing element through a respective hole in the tissue and causing each securing element to rotate to a position that inhibits the securing element from passing through the respective hole.

Abstract: A delivery catheter for a gastric reduction system includes an elongate torqueable tube, a needle translatably disposed within the torqueable tube, an anchor translatably disposed within the needle and a stabilization device for holding a distal tip of the torqueable tube against a tissue wall.

Abstract: An improved method of selectively annealing a needle and the needle prepared by the improved method is disclosed. A curved needle is positioned adjacent a flat electromagnetic induction coil. The curved body of the needle is positioned in a plane parallel with the coil plane of the flat induction coil. A current is delivered through the coil to selectively heat and consequently selectively anneal a portion of the needle. The improved method enables the selective annealing of curved needles, and is especially useful for the manufacture of surgical needles.

Abstract: In a system with a surgical needle and a handle, the surgical needle has in its proximal end-section, lying opposite the needle tip, a holding section (14), which is set up for insertion into the handle. The handle has a channel (32), set up for holding the holding section (14) of the surgical needle, and a locking device (50, 70) with a locking element (50) which is displaceable in longitudinal direction of the channel (32) from a locking position, in which the holding section (14) is fixed to the handle, into a release position, in which the holding section (14) can be pulled out from the channel (32).

Abstract: A needle array adapted to deliver sutures for the anastomosis of two separated tissues through the intermediary of suturing and sewing. More particularly, provided is needle array delivering sutures for the side-to-side anastomosis of two separated vessels, such as an artery or body lumen and a vessel graft or the like. A method of utilizing a needle array is shown, which will provide sutures for sewing separated tissues together, and especially facilitates the side-to-side anastomosis of body lumens or vessels.

Abstract: Disclosed is a closure catheter, for closing a body cavity such as a vessel, or the left atrial appendage of the heart. The closure catheter includes a plurality of deployable tissue anchors, which may be laterally deployed into surrounding tissue. The anchors may thereafter be used to draw the tissue radially inwardly, to close the body cavity. Methods are also disclosed.

Abstract: Devices and techniques for suturing are particularly useful in laparoscopic, arthroscopic, and/or open surgical procedures. A method of delivering a suture includes providing a suture device, releasably coupling a suture to a distal end of a suture device by threading the suture through a first region of a bounded opening of the suture device and moving the suture to a second region of the bounded opening having a dimension smaller than a diameter of the suture to trap the suture in the second region, penetrating a substrate with the distal end of the suture device such that the a portion of the suture passes through the substrate, and releasing the suture from the distal end of the suture device.

Abstract: A stopple for retaining material within a hollow needle/push rod assembly is made of a synthetic absorbable material and is configured to fit snugly within the hollow needle of the needle/push rod assembly. The stopple is typically circular in shape, having a diameter that is substantially similar to the inner diameter of the hollow needle. The stopple prevents inadvertent ejection of material stored in the hollow needle/push rod assembly.

Abstract: A siliconized surgical needle is provided which requires significantly less force to effect tissue penetration than a standard siliconized needle.

Abstract: A tissue connector assembly comprising a clip movable between an open configuration and a closed configuration and a mechanical restraining device attached to the clip for restraining the clip in its open configuration. A needle may be releasably attached to the clip. A method for connecting tissues is also disclosed. The method includes inserting a clip through tissue with the clip being biased in an open position by a restraining device secured to the clip, and removing the restraining device from the clip.

Abstract: Devices and methods for performing vascular anastomosis. A needle passer is used to pass one or more needles through tissue to thread one or more lengths of suture through the tissue. The needle passer is operable using one hand and includes a handle supporting a shaft assembly carrying first and second sets of needles connected by lengths of suture. An actuator assembly uncovers the first set of needles, moves them into a radially extended position, and then passes them through tissue, for example, the wall of a patient's aorta. The needle passer may be pistol-shaped with a trigger that is moved in one direction to sequentially uncover, radially extend, and move the first set of needles through the aorta around an aortotomy. The needles may then be pulled away from the patient to thread the suture through the tissue. A delivery device is used to deliver a member adapted to be secure to body tissue, such as a vascular conduit. The delivery device includes a shaft and a collar mounted for relative movement.

Abstract: A method for siliconizing surgical needles is provided whereby the needles are treated with acid before they are siliconized.

Abstract: A medical instrument for closing an opening for surgery in which a trocar is used, and a method of securely closing the opening. The instrument includes a hollow tube, into which is inserted an elongated actuating mechanism, having at least two needles that can be positioned in a closed or open position. By securing a suture on the needles, inserting the instrument into the surgical opening, placing the needle into the open position, withdrawing the instrument through the body tissue, and tying the sutures, a secure closure of the surgical opening can be achieved.

Abstract: A system for performing minimally invasive cardiac procedures. The system includes a pair of surgical instruments that are coupled to a pair of robotic arms. The instruments have end effectors that can be manipulated to hold and suture tissue. The robotic arms are coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the end effectors. The movement of the handles is scaled so that the end effectors have a corresponding movement that is different, typically smaller, than the movement performed by the hands of the surgeon. The scale factor is adjustable so that the surgeon can control the resolution of the end effector movement. The movement of the end effector can be controlled by an input button, so that the end effector only moves when the button is depressed by the surgeon.